NPI:
1699182410
Provider Name:
SHADOW MOUNTAIN LLC.
Doing Business As: SHADOW MOUNTAIN RECOVERY, DENVER
Classification:
Clinic/Center - 261QR0405X
Entity Type:
Organization
Specialization: Rehabilitation, Substance Use Disorder
CLIA Number: 32D2212631
Address:
8200 E. BELLEVIEW BLVD.
SUITE 400E
GREENWOOD VILLAGE, CO
ZIP 80111
Phone:
(303) 420-9430
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SHADOW MOUNTAIN LLC. is a rehabilitation and substance use disorder clinic center in Greenwood Village, CO. SHADOW MOUNTAIN LLC. NPI is 1699182410. The provider is registered as an organization entity type.
The provider Is Doing Business As Shadow Mountain Recovery, Denver.
The provider's business location address is:
8200 E. BELLEVIEW BLVD.
SUITE 400E
GREENWOOD VILLAGE, CO
ZIP 80111
Phone: (303) 420-9430
Fax: (720) 360-0202
The provider's authorized official is Jackie Holub .
The authorized official title is Vice President and has the following contact phone number (925) 389-8591.
The CLIA number assigned to this NPI record is 32D2212631 - other - sud treatment with a certificate type of Certificate of Waiver.
The enumeration date for this NPI number is 7/14/2014 and was last updated on 4/26/2017.